Colchicina en la prevención secundaria de la enfermedad arterial coronaria, una potencial opción terapéutica

Piter Martínez Benítez, Flor Heres Álvarez, Loipa Galán Martínez, Leonardo López Ferrero, Yanitsy Chipi Rodríguez, Omar González Greck

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Resumen

Las estrategias para la reducción de la inflamación y su eficacia en prevenir la aterosclerosis y sus complicaciones  es un tema de actualidad en la investigación cardiovascular. Entre los fármacos  dirigidos a modular el proceso inflamatorio aterotrombótico, la colchicina,   utilizado desde la antigüedad  para el tratamiento de la gota y más recientemente en el tratamiento de la pericarditis recurrente y la fibrilación auricular  post cirugía cardiaca, ha emergido como un agente potencialmente útil para estos fines. Estudios recientes han evaluado el papel de la colchicina en el tratamiento de la enfermedad arterial coronaria estable, el síndrome coronario agudo y la restenosis en pacientes tratados mediante intervencionismo coronario percutáneo, con resultados alentadores. Su amplia disponibilidad y los limitados efectos secundarios han contribuido a que varios ensayos clínicos se realicen en la actualidad con el objetivo de evaluar su utilidad en este contexto.  En la presente revisión se describen las  características generales, las propiedades farmacológicas así como  la evidencia disponible respecto a los beneficios del  tratamiento con colchicina en la prevención secundaria de la enfermedad arterial coronaria.

 

Palabras clave

Inflamación, colchicina, enfermedad arterial coronaria

Referencias

BIBLIOGRAFIA

Mann D, Zipes DP, Libby P, Bonow RO,editors. BRAUNWALD Tratado de cardiología: Texto de medicina cardiovascular. Vol 1. 10a Ed. Elsevier. Madrid. España. 2015.

Anuario Estadístico de Salud. Cuba. 2017. Disponible en: files.sld.cu/dne/files/2018/04/Anuario-Electronico-Español-2017-ed-2018.pdf.Consultado enero 2019.

Khambhati J, Engels M, Allard-Ratick M, Sandesara PB, Quyyumi AA, Sperling L. Immunotherapy for the prevention of atherosclerotic cardiovascular disease: Promise and possibilities. Atherosclerosis. 2018; 276: 1-9.

Montecucco F, Liberale L, Bonaventura A, Vecchiè A, Dallegri F, Carbone F. The role of inflammation in cardiovascular outcome. Curr Atheroscler Rep. 2017; 19: 11. DOI 10.1007/s11883-017-0646-1.

Arbel Y, Abuzeid W, Rosenson RS, Weisman A, Farkouh ME. Old drugs for new indications in cardiovascular medicine. Cardiovasc Drugs Ther. 2018; 32:223-32. doi: 10.1007/s10557-018-6785-y.

Bäck M, Hansson G K. Anti-inflammatory therapies for atherosclerosis. Nat Rev Cardiol. 2015; 12: 199–211; published online 10 February 2015; doi:10.1038/nrcardio.2015.5.

Ridker M, Narula J. Will Reducing Inflammation reduce vascular Event rates? JACC: Cardiovascular Imaging Oct 2017, 2432; DOI: 10.1016/j.jcmg.2017.10.001.

Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, et al, CANTOS Trial Group. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017; 377:1119-31. doi: 10.1056/NEJMoa1707914.Epub 2017 Aug 27. PubMed PMID: 28845751.

Angelidis C, Kotsialou Z, Kossyvakis C, Vrettou AR, Zacharoulis A, Kolokathis F, et al. Colchicine pharmacokinetics and mechanism of action. Curr Pharm Des. 2018; 24: 659-63. DOI: 10.2174/1381612824666180123110042

Leung YY, Hui LLY, Kraus VB. Colchicine --- update on mechanisms of action and therapeutic uses. Semin Arthritis Rheum. 2015; 45:341-350. doi:10.1016/j.semarthrit.2015.06.013.

Nidorf SM, Thompson PL. Why colchicine should be considered for secondary prevention of atherosclerosis: An overview. Clin Ther. 2019; 41:41-8.

Tong DC, Wilson AM, Layland J. Colchicine in cardiovascular disease: an ancient drug with modern tricks. Heart. 2016; 102:995–1002.

Lennerz C, Barman M, Tantawy M, Sopher M, Whittaker P. Colchicine for primary prevention of atrial fibrillation after open-heart surgery: Systematic review and meta-analysis. Int J Cardiol. 2017; 249: 127-37.

Hemkens LG, Ewald H, Gloy VL, Arpagaus A, Olu KK, Nidorf M, et al. Colchicine for prevention of cardiovascular events. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD011047. DOI: 10.1002/14651858.CD011047.

Verma S, Eikelboom JW, Nidorf SM, Al-Omran M, Gupta N, Teoh H, et al. Colchicine in cardiac disease: a systematic review and meta-analysis of randomized controlled trials. BMC Cardiovasc Disord. 2015; 15:96. doi:10.1186/s12872-015-0068-3.

Papageorgiou N, Briasoulis, A, Lazaros G, Imazio M, Tousoulis D. Colchicine for prevention and treatment of cardiac diseases: A meta‐analysis. Cardiovasc Ther. 2017; 35: 10-8.

Salih M, Smer A, Charnigo R, Ayan M, Darrat YH, Traina M, et al. Colchicine for prevention of post-cardiac procedure atrial fibrillation: meta-analysis of randomized controlled trials. Int J Cardiol.2017; 243: 258-62.

Nidorf SM, Eikelboom JW, Thompson PL. Colchicine for secondary prevention of cardiovascular disease. Curr Atheroscler Rep. 2014 16:391. DOI 10.1007/s11883-013-0391-z.

Casanova P, Artola RT, Mihos CG, Pineda AM, Santana O. The cardiovascular effects of colchicine: A comprehensive review . Cardiol Rev. 2015; 23:317-322.

Lin B, Pillinger M, Shah B, Tenner C. Use of colchicine in atherosclerotic heart disease. J Emerg Dis Prev Med.2018; 1:2-4.

Fiolet ATL, Nidorf SM, Mosterd A, Cornel JH. Colchicine in stable coronary artery disease. Clin Ther. 2019; 41:30-40.

Slobodnick A, Shah B, Pillinger MH, Krasnokutsky S. COLCHICINE: OLD AND NEW. Am J Med. 2015; 128: 461–70. doi: 10.1016/j.amjmed.2014.12.010.

Chappey ON, Niel E, Wautier JL, Hung PP, Dervichian M, Cattan D, et al. Colchicine disposition in human leukocytes after single and multiple oral administration. Clin Pharmacol Ther. 1993; 54:360–7. Available at: http://www.ncbi.nlm.nih.gov/pubmed/8222477.

Leung YY, Yao HLL, Kraus VB. Colchicine--Update on mechanisms of action and therapeutic uses. Semin Arthritis Rheum. 2015;45:341-50.

US Food and Drug Administration. Drug development and drug interactions: table of substrates, inhibitors and inducers. http:// www. fda.gov/Drugs/ DevelopmentApprovalProcess/DevelopmentResources/DrugInteractionsLabeling/ucm093664.htm (2011).

Nidorf SM, Eikelboom JW, Budgeon CA, Thompson PL. Low-dose colchicine for secondary prevention of cardiovascular disease. J Am Coll Cardiol. 2013; 61:404–10. doi:10.1016/j.jacc.2012.10.027.

Cecconi A, Vílchez JP, De Castro JM, López-Melgar B, Sánchez-González J, Ruiz-Cabello J, et al. Efecto de la colchicina sobre la placa ateroesclerótica en un modelo de ateroesclerosis avanzada de aorta en el conejo. Rev Esp Cardiol. 2016:69 Supl 1:183.

Nidorf M, Thompson PL. Effect of colchicine (0.5 mg twice daily) on high-sensitivity C-reactive protein independent of aspirin and atorvastatin in patients with stable coronary artery disease. Am J Cardiol. 2007; 99:805–7. doi:10.1016/j.amjcard.2006.10.039. 58.

Crittenden DB, Lehmann RA, Schneck L, Keenan RT, Shah B, Greenberg JD, et al. Colchicine use is associated with decreased prevalence of myocardial infarction in patients with gout. J Rheumatol. 2012; 39:1458–64.

Solomon DH, Liu C, Kuo I, Zak A, Kim SC. Effects of colchicine on risk of cardiovascular events and mortality among patients with gout: a cohort study using electronic medical records linked with Medicare claims. Ann Rheum Dis. 2015; 0:1–6. doi:10.1136/annrheumdis-2015-207984.

Quiles J, Miralles-Vicedo B. Estrategias de prevención secundaria del síndrome coronario agudo. Rev Esp Cardiol. 2014; 67:844-848. DOI: 10.1016/j.recesp.2014.04.015.

Vaidya K, Martínez G, Patel S. The role of colchicine in acute coronary syndromes. Clin Ther. 2019; 41:11-20.

Martínez GJ, Robertson S, Barraclough J, Xia Q, Mallat Z, Bursill C, et al. Colchicine acutely suppresses local cardiac production of inflammatory cytokines in patients with an acute coronary syndrome. J Am Heart Assoc. 2015; 4:e002128. doi: 10.1161/JAHA.115.002128.

Akodad M, Fauconnier J, Sicard P, Huet F, Blandel F, Bourret A, et al. Interest of colchicine in the treatment of acute myocardial infarct responsible for heart failure in a mouse model. Int J Cardiol .2017; 240: 347-53. https://doi.org/10.1016/j.ijcard.2017.03.126.

Robertson S, Martínez GJ, Payet CA, Barraclough JY, Celermajer DS, Bursill C, et al. Colchicine therapy in acute coronary syndrome patients acts on caspase-1 to suppress NLRP3 inflammasome monocyte activation. Clin Sci (Lond). 2016; 130:1237-46. doi: 10.1042/CS20160090.

Deftereos S, Giannopoulos G, Angelidis C, Alexopoulos N, Filippatos G, PapoutsidakisN, et al. Antiinflammatory treatment with Colchicine in acute myocardial infarction: A Pilot Study. Circulation.2015; 132:1395–1403.doi: 10.1161/ CIRCULATIONAHA.115.017611.

Raju NC, Yi Q, Nidorf M, Fagel ND, Hiralal R, Eikelboom JW. Effect of colchicine compared with placebo on high sensitivity C-reactive protein in patients with acute coronary syndrome or acute stroke: a pilot randomized controlled trial. J Thromb Thrombolysis. 2012; 33:88-94.

Vaidya K, Arnott C, Martínez GL, Ng B, McCormack S, Sullivan DR, et al. Colchicine therapy and plaque stabilization in patients with acute coronary syndrome: A CT coronary angiography study. JACC: Cardiovasc Imaging. 2017. Article in press. DOI: 10.1016/j.jcmg.2017.08.013.

Forrester JS, Fishbein M, Helfant R, Fagin J. A paradigm for restenosis based on cell biology: Clues for the development of new preventive therapies. J Am Coll Cardiol. 1991; 17:758-69. ; DOI: 10.1016/S0735-1097(10)80196-2.

Bhattacharyya B, Panda D, Gupta S, Banerjee M. Anti-mitotic activity of colchicine and the structural basis for its interaction with tubulin. Med Res Rev. 2008; 28:155–83.

Atta HM, El-Rehany MA, Abdel Raheim SR, Fouad R, GalalAM. Colchicine inhibits intimal hyperplasia and leukocyte VEGF expression in dogs. J Surg Res. 2008; 146:184–9.

O’Keefe JH, McCallister BD, Bateman TM, Kuhnlein DL, Ligon RW, Hartzler GO. Ineffectiveness of colchicine for the prevention of restenosis after coronary angioplasty. J Am Coll Cardiol. 1992; 19:1597–600.

Freed M, Safian RD, O’Neill WW, Safian M, Jones D, Grines CL. Combination of lovastatin, enalapril, and colchicine does not prevent restenosis after percutaneous transluminal coronary angioplasty. Am J Cardiol. 1995; 76:1185–8.

Deftereos S, Giannopoulos G, Raisakis K, Kossyvakis C, Kaoukis A, Panagopoulou V, et al. Colchicine treatment for prevention of bare-metal stent restenosis in diabetics. J Am Coll Cardiol. 2013; 61:1679–85.

Shah B, New York University School of Medicine. Anti-inflammatory Effects of Colchicine in PCI. https://clinicaltrials.gov/ct2/show/NCT01709981.

ClinicalTrials.gov. Colchicine and spironolactone in patients with STEMI / SYNERGY stent registry (CLEAR-SYNERGY). October 25, 2017 [cited 2017 Dec 10]; Available from: https://clinicaltrials.gov/ct2/show/NCT03048825.

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Copyright (c) 2019 Piter Martínez Benítez, Flor Heres Álvarez, Loipa Galán Martínez, Leonardo López Ferrero, Yanitsy Chipi Rodríguez, Omar González Greck

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